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Double dose once a week?

I responded we'll to loading doses, but not so well once I switched to maintenance. Did one week of 2 pens, and now on weekly doses. Anyone do double dose each week?

Worried about side effects, but my body seems to metabolize Humira quickly. Also running out of drug options, so would prefer not to abandon it yet, but single dose only lasting 4-5 days.
 
Some people in the US do one shot a week, if the fortnightly shot is not working, if their insurance approves it. But in Australia our Medicare will not approve it for weekly shots or less. So, all you can do I think is ask your doctor.
 

PsychoJane

Moderator
I'd be worried a little to take it twice a week. I don't have the knowledge to really understand the whole process behind these reaction but from what I understand, you built up some sort of tolerance to humira from the fact your systems develops antibodies to the humira molecule. If you have enough antibody to allow the clearance of the medication in such a short laps, I believe that it would mean that your body would be likely to build even more antibodies if you would do shots twice a week. Now I would start questioning if there is a risk for your system to have that many Humira antibodies? Unfortunately I don't have the answer to that, maybe Kiny could have an opinion on the subject...

Sorry you are running out of option:( Have you been on Remicade already?
 
Thank you for your responses!

I have already done Remicade - approx. 30 treatments between 2002 and 2009. Got pregnant and was in remission, so went off. Was able to stay drug feel until late last year, and decided to try Remicade again, but on my second infusion had a (minor) reaction - chest tightening and flushing, which went away when the drug was turned off. I was already pre-medicated with steroids and benadryl. Tried one more, and same thing, so had to quit. It wasn't working as well as it used to anyway.

Humira was next - started end March 2013. Like I mentioned above, responded well to loading doses, but symptoms back with fortnightly, and now weekly as well. I maybe got one-two days of slight improvement this week.

Gra - I have excellent insurance and they are covering weekly and would cover twice weekly as well.

I will do some more digging to see about side effects and antibodies on higher doses.

Thanks again for your responses. Go see my GI next week. They have mentioned Simponi as a possible next step as well. I am in a town with a university so they are often running clinical trials.
 

PsychoJane

Moderator
Are they not considering the use of a concomitant immunomodulator? I am under the impression you have a very rapid developpement of autibodies and it could be beneficial to add something like methotrexate, AZA or 6-mp in order to diminish the tolerance? Was that mentioned to you at some point?
 
Thanks again. We did discuss it at the beginning, as I was on Imuran for quite a while and it worked for me. I will ask again. I can't remember the reasoning for not, but I think he wanted to try Remicade and then Humira alone first.

I think he has avoided methotextrate so far because I may have another child in the near future and you have to wait at least 6 months before conceiving.
 
Sticking with weekly Humira for now and adding
Cipro and Flagyl to try to get some fistula relief while waiting for a surgical consult on the fistula.

Desperately trying to avoid Prednisone, but feeling a bit sorry for myself and also maybe a bit silly for being such a baby about taking it.

Doc might be able to get his hands on Simponi or Stelara but going to give Humira a bit more time.

He had not ever put anyone on double dose weekly and was not keen on that at all. There is one study I would be eligible for but Humira was out period is 10 weeks, and that seems like a long way off.

He didn't think Imuran would make much pact at this point, and we are still avoiding methotrexate because of pregnancy concerns.
 
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